JCPSLP November 2017

Phase 2. Placement Environment and learning opportunities

Students attend informal, interactive, fun language lessons at the end of each day to continue their immersion in the local language and build on their understanding of speech, language, and the culture of the local and broader community. Competency assessment Students are supervised by experienced clinical educators from the university throughout the placement and formally assessed using COMPASS®: Competency Assessment in Speech-language Pathology (McAllister et al., 2013). Mid-placement evaluation and feedback occurs early in the placement to allow for the modification and extension of the student’s learning goals to support continuing skill development. Reflection in and on action A key aspect of skill development, and the care of the attending students, is to allow frequent opportunities to debrief and to reflect on action. Reflection, as widely acknowledged throughout the health professions, is vital to allow active learning from experience (Mann, Gordon, & MacLeod, 2009). However, reflection is also an opportunity to resolve interpersonal conflict (Epstein, 1999) which becomes vital in a complex setting that challenges students’ notions of culture, values, and practice. Further, the opportunity to both debrief and reflect as a group and individually becomes vital when the stress of travelling away from home, in a hot unfamiliar setting, with unfamiliar language and food, is added. Reflection not only provides active learning for the students but also enables pastoral care and development of professional skills. Students engage in individual reflection following each clinical session, and in a group at the end of each clinical day and on their return to Australia. Each student also provides written journal style reflections at least once to their clinical educator during their clinical placement and as part of their final portfolio assessment on return to Australia. Supervision and pastoral care As Balandin and colleagues observe (2007), the physical and mental well-being of students on international placements is critical to the success of these placements. The complex caseload often requires a high level of supervision initially, and understanding from clinical educators that modelling, joint sessions, and provision of supporting literature and resources may be required in order to facilitate learning and high-quality service delivery in a short amount of time. These scaffolds can also, typically, be faded out in a relatively short amount of time. On a sheer practical level, students have also required pastoral care taking the place of additional support and guidance in relation to a range of physical and emotional needs while on placement in Viet Nam. As adult learners the students are expected to take responsibility for their own mental and physical well-being. However, circumstances do arise, (typhoons, heat stroke, food poisoning, bag snatching, long distance break-ups to name a few) that can require the clinical educator to provide emotional support in these situations which involves assisting students to alleviate feelings of stress, anxiety and inadequacy. Clinical educators stay in the same location as the students to allow this to occur more easily. Again, the familiarity of clinical educators with the environment due to repeat visits to the same placement sites also facilitates provision of pastoral care. Experience in clinical education

Students commence their placement in Ho Chi Minh City, Viet Nam, where the UON has developed partnerships with Pham Ngoc Thach University of Medicine (PNTU) and Trinh Foundation Australia (TFA). The students (supported by a clinical educator from UON) attend hospitals, centres and schools over four days to observe a varied caseload of adult and paediatric clients and provide education through discussion and structured workshops. This part of the placement allows both the Vietnamese speech-language pathologists and UON students to develop networks of support, build professional relationships, reflect on their own practice and develop skills in their supervision of others. Students then travel to Hoi An where the UON has also developed a strong partnership with the Kianh Foundation and staff at the Kianh Foundation Day Centre (Kianh). Students attend Kianh each day for three weeks, supervised directly by clinical educators affiliated with the UON. The focus of service delivery at Kianh is determined by the needs, wants and goals of key stakeholders (children, special education teachers, support teachers, interpreters, and other volunteers). Intervention has been provided individually, in small groups, and in whole class sessions and has targeted a range of communication skills including: speech, intelligibility, pre-linguistic skill development, language development, comprehension, use of visual support systems, sign language and AAC devices. There has also been a focus on oral and pharyngeal dysphagia. The importance of capacity building Trust, relationships and partnerships are often formed through mutual understanding and working together (Hoy et al., 2010). The NUSpeech model focuses on working in collaboration with the host organization to capacity build, whereby teachers and therapists are included and integrated into all individual, group or class sessions, discussion groups and workshops. Ongoing professional development for all key stakeholders is a key aspect of the placement and new learning needs to be culturally appropriate, meaningful and valued by the local communities. Unsolicited feedback from one of our new partners in Viet Nam highlights the benefits of the placement to their organisation: One of my most treasured connections has been the introduction to Dr Sally Hewat, Senior Lecturer and Head of Speech Pathology at the University of Newcastle. Thanks to Sally we were blessed to have 2 final-year Speech Pathology Students … & their Clinical Educator … spend time with us at our school this year. They assessed all our students speaking abilities, provided training for our teachers & set up programs for our teachers to follow when we have no “Speechies”. This pilot project was a huge success for everyone involved &, I’m thrilled to announce, it looks as if this will be an ongoing collaboration …. Again, our students’ lives have been so enriched by the generosity of others. Language lessons, interpreters and translation An innovative feature of the placement is the opportunity for students to engage in learning the language on-site.

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JCPSLP Volume 19, Number 3 2017

Journal of Clinical Practice in Speech-Language Pathology